Reconstruction of Heel Defect Occured by Verrucous Carcinoma

Seung Ki Ahn; Hwan Jun Choi; Si Hyong Jang

doi:10.12790/ahm.2018.23.1.54

Journal List > Arch Hand Microsurg > v.23(1) > 1106631

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Ahn, Choi, and Jang: Reconstruction of Heel Defect Occured by Verrucous Carcinoma

Case Report

Arch Hand Microsurg 2018;23(1):54-58.

Published online: 5 January 2018

DOI: https://doi.org/10.12790/ahm.2018.23.1.54

Reconstruction of Heel Defect Occured by Verrucous Carcinoma

Seung Ki Ahn¹, Hwan Jun Choi¹, Si Hyong Jang²

¹Department of Plastic and Reconstructive Surgery, Soonchunhyang University, Cheonan, Korea

²Department of Pathology, College of Medicine, Soonchunhyang University, Cheonan, Korea

Correspondin gauthor: Hwan Jun Choi Department of Plastic and Reconstructive Surgery, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan 31151, Korea TEL: +82-41-570-2195, FAX: +82-41-574-6133, E-mail: medi619@schmc.ac.kr

This work was supported by the Soonchunhyang University Research Fund.

Received 24 July 201723 January 2018 Accepted 24 January 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

초록

Verrucous carcinoma is a low-grade, well differentiated uncommon variant of squamous cell carcinoma and may grow large and can destroy adjacent tissue such as bone and cartilage. A 45-year-old male patient presented with chief com-plaints of growth mass of the left foot. He is known diabetic, hypertensive, chronic venous insufficiency and related ulcerations on the lower legs. There is a tender, ulcero-proliferative mass on foot. The result of biopsy showed a highly differentiated verrucous carcinoma. At first the patient underwent wide excision and biopsy with mesh split thickness skin graft. But after 4 months that surgery, verrucous carcinoma recurred with ulceration. Because tumor infiltrated the soft periosteal tissues and calcaneus, he need flap coverage or amputation. We decide to reconstruct heel with anterolateral thigh perforator free flap. The goal of heel reconstruction should be functional and aesthetic. Below knee amputation was not performed, so the patient's quality of life increased.

Keywords: Verrucous carcinoma, Anterolateral thigh free flap, Heel defect, Amputation, Diabetic foot

REFERENCES

1.Abhivardhan D., Bhadram V., Kumar S., Jagadeesh AB., Su-shma P. Verrucous carcinoma of the leg - a rare variant of squamous cell carcinoma in an unusual site: a case report. Int J Sci Stud. 2015. 3:128–30.

2.Ackerman LV. Verrucous carcinoma of the oral cavity. Surgery. 1948. 23:670–8.

3.Steffen C. The man behind the eponym: Lauren V. Ackerman and verrucous carcinoma of Ackerman. Am J Derma-topathol. 2004. 26:334–41.

4.Tornes K., Bang G., Str⊘mme Koppang H., Pedersen KN. Oral verrucous carcinoma. Int J Oral Surg. 1985. 14:485–92.

5.Medina JE., Dichtel W., Luna MA. Verrucous-squamous carcinomas of the oral cavity. A clinicopathologic study of 104 cases. Arch Otolaryngol. 1984. 110:437–40.

6.Delahaye JF., Janser JC., Rodier JF., Auge B. Cuniculatum carcinoma. 6 cases and review of the literature. J Chir (Paris). 1994. 131:73–8.

7.Green JG Jr., Ferrara JA., Haber JA. Epithelioma cunicula-tum plantare. J Foot Surg. 1987. 26:78–83.

8.Ascione T., Iannece MD., Rosario P, et al. Impact of thera-peutic choices on outcome of osteomyelitis caused by MRSA. J Infect. 2011. 63:102–4.

9.Tiemann AH., Hofmann GO. Principles of the therapy of bone infections in adult extremities: are there any new developments? Strategies Trauma Limb Reconstr. 2009. 4:57–64.

10.Wright PK., Vidyadharan R., Jose RM., Rao GS. Plantar verrucous carcinoma continues to be mistaken for verruca vulgaris. Plast Reconstr Surg. 2004. 113:1101–3.

Fig.1.

Preoperative image of the ulcerative masses on both the ankle and heel.

Fig.2.

After wide excision of the mass on the left foot and debridement.

Fig.3.

Recurrence of verrucous carcinoma on the heel.

Fig.4.

(A) The tumor showed a downward growing solid bulbous infiltrative nest (H&E, ×12.5). (B) The tumor consisted of well differentiated squamous cells (H&E, ×400).

Fig.5.

After 1 year follow-up of anterolateral thigh free flap operation.

TOOLS

Similar articles